On-demand inhalation effective in bronchiolitis

(HealthDay)—In infants with acute bronchiolitis, on-demand inhalation of either adrenaline or saline are effective in shortening hospital stays and reducing the need for supportive treatment, compared with fixed-schedule inhalation, according to a study published in the June 13 issue of the New England Journal of Medicine.

Havard Ove Skjerven, M.D., from the Oslo University Hospital in Norway, and colleagues randomly assigned 404 infants (<12 months old) with moderate-to-severe acute bronchiolitis to inhaled racemic adrenaline (on-demand or fixed-schedule inhalation) or inhaled saline (on-demand or fixed-schedule inhalation). Fixed-schedule inhalation was up to every two hours.

The researchers found that inhaled adrenaline and inhaled saline offered similar results in terms of length of hospital stay, use of oxygen supplementation, nasogastric-tube feeding, ventilator support, and relative improvement in illness severity. However, on-demand inhalation was significantly better than fixed-schedule inhalation in terms of estimated mean length of stay (47.6 versus 61.3 hours), use of oxygen supplementation (38.3 versus 48.7 percent of infants), and number of inhalation treatments (12.0 versus 17.0).

"The administration of inhalations on demand, as compared with a fixed schedule of inhalations, was associated with a shorter hospital stay and with a reduced need for supportive treatment," Skjerven and colleagues conclude.

Two authors disclosed financial ties to pharmaceutical companies.